Means for internal fixation of fractured bones



Dec. 9, 1952 P. coRDAsco 2,620,792

MEANS FOR INTERNAL FIXATION OF" FRACTUREID BONES Filed Dec. 5, 1950 2SHEETSSHEET l Dec. 9, 1952 P. CORDASCO MEANS FOR INTERNAL FIXATION OFFRACTURED BONES 2 SHEETS-SHEET 2 Filed Dec. 5, 1950 Patented Dec. 9,1952 UNITED STATES PATENT OFFICE MEAN S FOR INTERNAL FIXATION OFFRACTURED BONES 2 Claims.

This invention relates to an appliance, particularly a nail or pin, foruse in the internal fixation of fractured bones; and the inventioncontemplates devices of this character for fixing fractures of the neckof the femur and also fractures of long bones such as the shaft of thefemur.

One object of the present invention is to provide fracture fixationmeans which shall embody novel and improved features of constructionwhereby it shall effectively resist all strains, particularly torsionaland bending strains, at the plane of the cleavage of fracture of thebone.

Another object is to provide a fracture nail or pin which shall be soconstructed that it can be easily driven into position and shall havefirm bearing or contact with the bone fragments throughout its length soas to strongly resist all strains at the plane of fracture.

Other objects, advantages and results of the invention will be broughtout by the following description in conjunction with the accompanyingdrawings in which Figure l is a front elevational view of a fixationnail embodying the invention, illustrating it in position for thefixation of an intracapsular fracture of the femoral neck at the hipjoint, with the bone shown partially in vertical section;

Figure 2 is a side elevational view of the thigh bone and fixation nailas illustrated in Figure 1;

Figure 3 is a transverse vertical sectional view approximately on theplane of the line 3-3 of Figure 1;

Figure 4 is a side elevational view of the fixation nail;

Figure 5 is a vertical longitudinal sectional view through the fixationnail;

Figure 6 is an enlarged and elevational view of the fixation nail;

Figure 7 is a front elevational view of a modified form of the nail;

Figure 8 is a composite side elevational view of fragments of afractured thigh bone and a front elevation of a form of the inventionadapted for the fixation of fractures of long bones, illustrating themanner of applying the fixation means to the bone;

Figure 9 is a vertical longitudinal section through the bone showing thebone fragments fixed by the fixation pin which is illustrated in frontelevation;

Figure 10 is a fragmentary side elevational view of the bone andfixation pin as illustrated in Figure 9;

Figures 11 and 12 are fragmentary front ele-.- vational and sideelevational views, respectively of the fixation pin showing the mannerof fiexing of the pin and the method of removal of the pin from thebone.

Specifically describing the embodiment of the invention illustrated inFigures 1 to .6 inclusive, the fracture fixation member A is formed ofany suitable corrosion resistant material, preferably stainless steeland is preferably I-shaped in cross section and of a length suificientfor the fixation of the particular fracture involved, in the presentinstance a fracture of the femoral neck at the hip joint.

In this form of the invention, the member is in the nature of a nail andcomprises a fiat web portion 1 having a flange 2 at each of itslongitudinal edges extending perpendicularly to the general plane of theweb, each flange extending approximately equidistantly from oppositefaces of the web as best shown in Figures 3 and 5. The inner surfaces 3of the flanges 2 are preferably straight and flat and perpendicular tothe plane of the web, while the outer surface 4 of each flange isarcuately cylindrical, for example about a center lying in thelongitudinal median plane of the web and mid-way of the thickness of theweb, the arcuate surfaces meeting the straight surfaces 3 in sharplongitudinal edges 5.

One end of the nail has a scimitar-like edge 6, and as shown this edgeis formed by convexly curving the end of the web and beveling said endto form a chisel-like edge. The width of the nail and the distancesbetween the outer surfaces 4 of the flanges will vary for differentpurposes, depending upon the size of the intramedullary canal, but inall cases the width of the nail preferably will be such that the flanges4 will penetrate the cortex of the bone B when the pin is driven intothe intramedullary canal as best shown in Figure 3. The end edges of theflanges 2 are also sharpened or beveled to cut the bone.

At its end opposite the scimitar edge, the nail is provided with anenlarged portion 1 that may have a central screw threaded socket 8 forconnection of a rod to be used in driving the nail into position. InFigure 7 the nail is shown as having a screw threaded stud 9 instead ofa socket l for connection to the rod of a driver.

The nail is used in generally known manner. However, the sharp edges 5of the longitudinal flanges 2 and the arcuately curved surfaces 4 of theflanges provide for easy and accurate cutting of the nail through thebone; and the arcuate flanges in addition provide firm contact with thecortex throughout their lengths. Therefore, the nail can be easilydriven into position with a minimum of discomfort to the patient and aminimum of damage to the bone, and at the same time the nail willeffectively resist all strains, particularlv torsional and bendinstrains at the plane of fracture. The scimitar edge 6 and the sharpenedend edges of the flanges 2 insure a smooth cutting of the bone with aminimum of wedge action that might tend to put undue stresses on thebone during the driving of the nail.

As usual, preferably the nail has so-called breathing apertures H) whichpermit free circulation of blood through the bone and also are useful inascertaining by X-ray the extent of penetration of the nail into thebone.

Figures 8 to 12 inclusive illustrate a form of the inventionparticularly adapted for the fixation of long bones such as the shaftsof femurs. Here the structure of the appliance or pin C is in generalthe same as that of the pin A, the main difference being in thedimensions. As shown, the pin C is much longer than the pin A, the pin Cbeing intended to extend through a major por tion of the length of theshaft of the femur.

This type of pin is applied to the bone in a different manner from thatin which the nail A is inserted into the bone. As shown in Figure 8, thebone fragments D and E are bent apart at the fracture and the head endll of the pin is inserted into the upper section D of the femur from thebroken end and pushed through the other end of the fragment as shown bysolid lines. The scimitar end of the pin is then inserted into thebroken end of the other bone fragment C and the bone fragments are movedinto longitudinal alignment with each other with the fractured ends inmutual abutment as shown by broken lines. Then the pin is driven intothe lower fragment C of the femur as shown by solid lines in Figure 9.The pin is preferably formed with a transverse opening I2 in its headfor the insertion of a hook or other suitable member I3 for pulling thepin out of the bone as shown by broken lines in Figure 9.

It will be observed that the pin is flexible both in directions parallelwith its plane as shown in Figure 11 and in directions perpendicular toits plane as shown in Figure 12 so as to conform to the curvature of thebone as best shown in Figures 9 and 10. Of course, if desired the pincould be initially curved to correspond to the shape of the bone andthis might be preferable in many cases.

While two now preferred embodiments of the invention have beenspecifically described, it will be understood by those skilled in theart that many modifications and changes may be made in the specificconstruction of the fixation member within the spirit and scope of theinvention,

I claim:

1. For use in the internal fixation of fractured bones, an elongatedmember including a web and a flange at each longitudinal edge thereofextending equidistantly from both faces of the web and havingsegmentally cylindrical outer surfaces whose center lies in thelongitudinal median plane of said web and centrally of the thicknessthereof, one end of said web being scimitarshaped and the correspondingends of said flanges being beveled to sharp edges.

2. For use in the internal fixation of fractured bones, an elongatedmember includin a flat web and a flange at each longitudinal edgethereof extending equidistantly from both faces of the web and havingstraight and fiat inner surfaces perpendicular to the plane of the web,said flanges also having segmentally cylindrical convex outer surfaceswhose centers lie in the longitudinal median plane of said web andcentrally of the thickness of the web, said curved outer surfacesmeeting said inner surfaces in sharp edges extending longitudinally ofthe flanges.

PETER CORDASCO.

REFERENCES CITED The following references are of record in the file ofthis patent:

UNITED STATES PATENTS Number Name Date 2,496,126 Haboush Jan. 31, 19502,536,964 Stephens Jan. 2. 1951

